Rhode Island Gov. Gina Raimondo has signed legislation requiring state insurers to reimburse chiropractors for medically necessary non-opioid pain treatments.1 The legislation, which takes effect April 1, 2018, includes several significant stipulations that directly benefit the state's doctors of chiropractic.2
Relative to the opioid crisis, which has been characterized as epidemic in Rhode Island and is spearheading ongoing legislative and policy changes nationwide: "Patients with substance use disorders shall have access to evidence-based non-opioid treatment for pain, therefore coverage shall apply to medically necessary chiropractic care, and osteopathic manipulative treatment."
The legislation also adds an important medical necessity requirement to existing unfair discrimination language:
"[W]henever the insurance policy, certificate, or service contract provides for reimbursement for any services which may be legally performed by any person licensed under the provisions of chapters 29, 30, 35 and 37 of title 5, reimbursement under the insurance policy, certificate, or service contract shall be based upon a determination of medical necessity and shall not be denied because of race, color, or creed, nor shall any insurer make or permit any unfair discrimination against particular individuals or persons licensed under chapters 29, 30, 35 and 37 of title 5." [Italics added]
Chiropractic physicians are recognized as licensed providers in Chapter 5-30 of the Rhode Island General Laws, Title 5: Businesses and Professions.3
Editor's Note: For another example of positive changes spurred by the opioid crisis, read "Coming Soon to a Hospital Near You" in this issue. That article discusses recent standards revisions by The Joint Commission, which accredits nearly 90 percent of U.S. hospitals.
References
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
